| NPI | 1154341485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER THOMAS LILLO Vice President Dentist 732-341-1120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ DI9702) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ DI19256) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |